Summary
Summary Medical Surgical Full Set of Notes
- Course
- Institution
Medical surgical full set of notes, in depth and well written. Common pathologies, lab values, interventions.
[Show more]
Seller
Follow
simonerodriguez
Content preview
FundamentalsLow income ppl: Medicaid: Medicare if disabled:
Primary prevention: immunization: health ed
Secondary: diagnosis and treatment: screening
Tertiary: provision of care
APs can reapply a condom catheter
Communicable diseases: TB- hepatitis A
Adolescents need iron, calcium, and vitamins A & C: need lots of protein
Preventing foot drop: keep foot dorsiflexed and use a trochanter roll
Perineal care: privacy; cleansing from front to back: drying thoroughly: retract penis foreskin
Working with an interpreter: speak directly to patient: tell interpreter purpose of convo:
Appropriate documentation:factual: accurately and concise: SOAP: PIE:DAR
Revising plan of care(pressure ulcers, wounds): hydration: wound cleansing: dehiscence- rupture
of wound: call for help: infection: purple by drainage: rest: antibiotic therapy:
Maintaining Aseptic technique: hand hygiene: masks, gowns, gloves, eyewear: don't shake
linens:
Crutch Safety: don't alter crutches: support body weight with elbows flexed at 30;
Confirming placement of NG tube in jejunum: aspirate stomach content to test pH: x-Ray
initially:
Peripheral catheter insertion: change sites every 72 hours; wipe ports with alcohol swab: check
distal veins first: advance the Catheter through the skin and into the vein: flashback should
occur: thread catheter into vein: pull back needle; release tourniquet: remove needle:
Gentamicin and furosemide: ototoxic
Fundamentals
Dietary Preferences
Buddhism- lacto-ovo: no alcohol
Hinduism: vegetarians or no beef/pork
,Islam: only meat that's ritually slaughtered
-body facing Mecca
Judaism: kosher diet or animals that are herbivores: can't eat milk and meat together
-24 HR fast for Yom Kippur: no shellfish
Asians: yin(cold) & yang(hot)
-thalassemia
Native American: TB & gallbladder
Herbs
-black cohosh: estrogen
-echinacea: immune system
-feverfew: anti inflammatory: migraines: fever: arthritis
-garlic: lower cholesterol
-ginger: antiemetic
-ginkgo- memory
-ginseng: stress and fatigue: increase endurance and stamina
Kava: antianxiety and muscle relaxant: sedative
-saw palmetto- antiestrogen: UTI & BPH
ST. JOHNS: antibacterial. Antiviral. Antidepressant.
HTN risk: native Americans. Latino Americans. Hispanics. AA
Paternalism: HCP decides what is best for the client and encourages the client to act against
his/her own choices
Fidelity: promise
Veracity: tell the truth
Ca2+: coagulation of blood; 8.6-10
Compensation=normal pH
Mg2*:1.6-2.6: clotting: neuromuscular
Metabolic acidosis: kidney failure. Toxins. Aspirin. Lactic acid. DK
Metabolic alkalosis: hypovolemia. Loss of gastric fluid. Excessive bicarbonate intake.
Transfusion. Hyperaldosteronism
Phosphorus: needed for bony tissue: 2.7-4.5
,Febrile transfusion: antibodies directed against WBC
Bacterial transfusion: transfusion of contaminated blood products
Third spacing: accumulation and sequestration of trapped extracellular fluid in an actual or
potential body space
Fluid volume deficit: increased HCT, BUN, NA, specific gravity, osmolality
Fluid volume overload: decreased HCT, BUN, NA, specific gravity, osmolality; crackles,
Isotonic overhydration: IV therapy. Kidney disease. Long term steroid use
Hypertonic overhydration: NA ingestion. Rapid infusion. Excessive bicarbonate
Hypotonic overhydration: early kidney disease. HF. SIADH. IV. wound irrigation
Decreased sodium excretion: steriods. Cushing's. Kidney disease. Hyperaldosteronism
HypoK: hypoactive bowel sounds: ST depression: shallow, flat, inverted T wave, U wave
HyperK: peaked T waves. Flat p waves. Wide QRS. Prolonged PR
Take liquid K with juice due to bad taste
-only give K PO or IV continuous infusion:NEVER IV push
-no more than 10-20HR
-always dilute:1/10 mL
HyperK: tissue damage. Acidosis. Hyperuricemia. Hypercatabolism
-Kayexalate: IV Ca2+: hypertonic glucose w/ insulin: fresh blood
HypoCa: Crohn's: steatorrhea; wound drainage:pancreatitis: alkalosis: decreased HR.
Hypotension. Diminished pulses: twitching
-warm injection to body temp: aluminum hydroxide. Vitamin D
HyperCA: thiazides diuretics: steriods: phosphorus. Calcitonin. Bisphosphonates. NSAIDs.
Dialysis: flank or abdominal pain=urinary stones
HypoMg: hyperglycemia; sepsis: insulin: Crohn's. Celiac. Tachy. HTN. Shallow respirations.
Twitches. Hyperreflexia
-fix Ca2+ levels
HyperMg: Brady. Hypo. Absent reflexes.
-calcium gluconate
-avoid laxatives and antacids
, Phosphorous:2.7-4.5
Hypo: hyperglycemia: respiratory alkalosis: decreased contractility
-weakness: confusion: seizures: decreased platelet aggregation
Hyper: tumor lysis syndrome: avoid laxatives and enemas.: take phosphate binding Meds with
meals
Acidosis: K moves out cell=hyperK
Respiratory -hypoventilation: high CO2
-endotracheal intubation or mechanical ventilation
-Metabolic: diabetes. Aspirin. High fat diet. Carbohydrates(lactic acidosis) Malnutrition. Renal
insufficiency. Diarrhea.
:Kussmaul's respiration
Alkalosis: K moves into cell=hypoK
-respiratory : hyperventilation: hysteria. Fever. Pain. Overventilation hypoxia
-decrease in CO2
: Metabolic: diuretics. Vomiting hyperaldosteronism. Excess bicarbonate. Transfusion:
suctioning
Allen's test: determines presence of collateral circulation: if pinkness doesn't return in 6-7
s=ulnar artery is insufficient and to not use radial artery
Respiratory
Elevated pH=decreased CO2: alkalosis
Decreased pH=elevated CO2: acidosis
Metabolic
Elevated pH=increased HCO3: alkalosis
Decreased pH=decreased CO2: acidosis
:Look at HCO3 for respiratory to determine compensation
:Look at CO2 for metabolic to determine compensation
Ileostomy: metabolic acidosis
Kussmaul's respirations: abnormally deep, regular, and increased in rate
Na:15 mEq/day: don't get from area of IV
K: high WBC & platelets=false elevated K
aPTT: clotting: plasma: 20-36 (60-80 Thera)
PT: clotting: 11-12.5(18-24 therapeutic)
INR:0.5-1;(2-3 therapeutic)
D-dimer test: measures clot formation and lysis that results from degradation of fibrin
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller simonerodriguez. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $15.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
79373 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now